Duplicate patient records in Manchester - the risks and how it happened

Hundreds of unnecessary and incorrect patient records have been created daily as hospital appointments were booked on the National Programme for IT’s Choose and Book system when linked to iSoft’s iPM system.

It has come to light after an Maintenance Release 1 upgrade of iPM system over the weekend of 21/22 April 2007.

The problem means that when appointments are made on some Choose and Book systems in Greater Manchester where the MR1 upgrade has been installed, and the system cannot find the patient’s correct identification number on the Personal Demographic Service of the National Programme for IT [NPfIT], it will create a duplicate record.

Connecting for Health, which runs the NPfIT, says that up to 400 duplicate records are being created every day. It denies there is any effect on the care and treatment of patients.

Internal documents show, however, that the problem is being categorised as a potential risk to safety. To avoid accurate patient data being lost in the mingling of correct and incorrect records, a team has been formed to merge the records carefully and safely.

In many cases this merging of the duplicate files and the known patient record is straightforward. In some cases it is not. If the duplicates and the main record have not been merged in time for an appointment, a patient may be seen at a clinic on the basis of the incorrect duplicate record, without potentially important medical history from the main file being available.

There are further risks if the merger of records is not done correctly. Connecting for Health says there will be a permanent fix in two to three weeks. Meanwhile the troubleshooting team is locked into trying to merge records safely.

A further problem is that the merged records may need unscrambling later, in the interests of data integrity, to ensure that patient administration systems have only one trustworthy version of the patient’s record. All this adds to workloads at a time when NPfIT specialists are said to be “fire-fighting”.

Related articles:

1) Duplicate patient records on Choose and Book, 200 major incidents in four months, and unnecessary NPfIT secrecy

2) National press follows up Computer Weekly’s article on National Programme for IT incidents

3) Is government trying to control information on problems after NPfIT go- lives?

4) Some examples of “Major Incidents“.

5) Connecting for Health attacks NHS users over reporting of major incidents